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Cited by 282Psychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up

Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M. A., Marttunen, M., Kaipainen, M. +2 more·2008·Psychological Medicine
DOI 10.1017/s003329170700164x
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Abstract

BACKGROUND: Insufficient evidence exists for a viable choice between long- and short-term psychotherapies in the treatment of psychiatric disorders. The present trial compares the effectiveness of one long-term therapy and two short-term therapies in the treatment of mood and anxiety disorders. METHOD: In the Helsinki Psychotherapy Study, 326 out-patients with mood (84.7%) or anxiety disorder (43.6%) were randomly assigned to three treatment groups (long-term psychodynamic psychotherapy, short-term psychodynamic psychotherapy, and solution-focused therapy) and were followed up for 3 years from start of treatment. Primary outcome measures were depressive symptoms measured by self-report Beck Depression Inventory (BDI) and observer-rated Hamilton Depression Rating Scale (HAMD), and anxiety symptoms measured by self-report Symptom Check List Anxiety Scale (SCL-90-Anx) and observer-rated Hamilton Anxiety Rating Scale (HAMA). RESULTS: A statistically significant reduction of symptoms was noted for BDI (51%), HAMD (36%), SCL-90-Anx (41%) and HAMA (38%) during the 3-year follow-up. Short-term psychodynamic psychotherapy was more effective than long-term psychodynamic psychotherapy during the first year, showing 15-27% lower scores for the four outcome measures. During the second year of follow-up no significant differences were found between the short-term and long-term therapies, and after 3 years of follow-up long-term psychodynamic psychotherapy was more effective with 14-37% lower scores for the outcome variables. No statistically significant differences were found in the effectiveness of the short-term therapies. CONCLUSIONS: Short-term therapies produce benefits more quickly than long-term psychodynamic psychotherapy but in the long run long-term psychodynamic psychotherapy is superior to short-term therapies. However, more research is needed to determine which patients should be given long-term psychotherapy for the treatment of mood or anxiety disorders.

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  • Because we restricted our inclusion criteria to manualised interventions, this is likely to have introduced some bias towards the inclusion of studies of CBT, and exclusion of psychological treatments from other treatment orientations such as psychodynamic psychotherapies.

    “Third, because we restricted our inclusion criteria to manualised interventions, this is likely to have introduced some bias towards the inclusion of studies of CBT, and exclusion of psychological treatments from other treatment orientations such as psychodynamic psychotherapies (e.g., see Knekt et al., 2008).”

    From Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood (2015) · cites this paper as Knekt et al., 2008

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Authors
Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M. A., Marttunen, M., Kaipainen, M., Renlund, C., & the Helsinki Psychotherapy Study Group
Affiliations
  • Social Insurance Institution (FI)
  • Helsinki University Hospital (FI)
Corresponding author
Knekt, P.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2007-11-16
Volume
38
Issue
5
Pages
689-703
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s003329170700164x
OpenAlex
W2093343421
Cited by
282
References
64
Citations by year
2026: 8 · 2025: 9 · 2024: 8 · 2023: 28 · 2022: 6 · 2021: 5 · 2020: 12 · 2019: 13 · 2018: 11 · 2017: 11 · 2016: 25 · 2015: 17 · 2014: 33 · 2013: 22 · 2012: 22
FWCI
11.64
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Helsingin ja Uudenmaan Sairaanhoitopiiri
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
psychodynamic psychotherapy, solution-focused therapy, brief psychotherapy, long-term psychotherapy, mood disorders, anxiety disorders, depressive symptoms, anxiety symptoms, treatment effectiveness, long-term follow-up
MeSH terms
Adult, Anxiety Disorders, Major Depressive Disorder, Depressive Disorder, Major, Female, Finland, Follow-Up Studies, Hospitalization, Humans, Long-Term Care, Male, Patient Dropouts, Personality Disorders, Personality Inventory, Problem Solving, Psychoanalytic Therapy, Psychotherapy, Brief

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